Family-centered approaches to understanding and preventing coronary heart disease

Kardia, Sharon L.R.; Modell, Stephen M.; Peyser, Patricia A.

doi:10.1016/s0749-3797(02)00587-1

Cited by 74 publications

(55 citation statements)

References 54 publications

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“…85,86 Family history of diabetes and major CVD events are reported fairly accurately, because each has a good case definition, both are serious enough to be of concern to relatives, and there is little stigma associated with them. 12,28,87 Even so, diabetes, in particular, is likely to be underreported; approximately one third of the people with diabetes have not had it diagnosed. 88 In addition to primary care, schools and national or state surveys are settings in which family history could be used as a screening tool to identify children who are at increased risk of chronic diseases.…”

Section: Family History As a Screening Toolmentioning

confidence: 99%

Is Family History a Useful Tool for Detecting Children at Risk for Diabetes and Cardiovascular Diseases? A Public Health Perspective

et al. 2007

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Several studies indicate that the risk for type 2 diabetes or cardiovascular disease is detectable in childhood, although these disorders may not emerge until adulthood. In addition, type 2 diabetes and cardiovascular disease seem to share risk factors, including obesity and dyslipidemia, and might even share etiology, which has important implications for screening and prevention strategies for both diseases. Primary prevention, in particular, has gained importance because the results of major randomized, controlled trials strongly suggest that, at least in high-risk adult groups, type 2 diabetes can be prevented or delayed. Furthermore, some intervention studies indicate that the risk factors for diabetes and cardiovascular disease can be reduced in children. A simple way to detect risk for either diabetes or cardiovascular disease is to examine the family history. Numerous studies have shown that adults who have 1 or more first-or second-degree relatives affected with diabetes or cardiovascular disease are at high risk of having or developing these diseases. Currently, there are no overall screening strategies recommended for either diabetes or cardiovascular disease among children and adolescents. The evidence is strong, however, that youth with a positive family history already show signs of increased risk for these conditions. Family history can be part of the approach to screening for children at risk of diabetes and cardiovascular disease and should be part of prevention campaigns aimed at reducing the burden of these diseases and their risk factors in children.www.pediatrics.org/cgi

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Section: Family History As a Screening Toolmentioning

confidence: 99%

Is Family History a Useful Tool for Detecting Children at Risk for Diabetes and Cardiovascular Diseases? A Public Health Perspective

et al. 2007

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“…The persistence of such epigenetic marks is of relevance to the origin of complex diseases, which are characterized by the absence of mendelian inheritance 90 . Here, the susceptibility of offspring to disease can depend on whether there is maternal or paternal history of disease as well as ethnicity 91 .…”

Section: Replication Of Ribotypesmentioning

confidence: 99%

The four Rs of RNA-directed evolution

Herbert

2003

Nat Genet

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The read-out of genetic information in eukaryotes is not only more complex than previously realized, but also more dynamic. Much of the information is 'soft-wired' , with extensive RNA processing necessary to generate phenotypes 10 . A subset of the RNA, referred to here as coRNA ( Fig. 1), coordinates the read-out of genetic information and reconciles regulatory inputs. For each cell type, the sum of these interactions defines a distinct RNA profile or ribotype 10 . RNA-based processes also facilitate replication of ribotypes in subsequent generations. The flexibility of these programs allows soft-wired organisms to evolve in a more rapid and dynamic way than 'hard-wired' organisms constrained by DNA mutation 10 . Together, the actions of reading, 'riting, 'rithmetic and replication constitute the four Rs of RNA-directed evolution. Here, we describe roles for coRNAs and SATs (Fig. 2) in these events. RNA-directed RNA readoutRNA coregulates the sequence-specific read-out of genetic information from RNA by targeting the evolutionarily conserved machinery of RNA interference (RNAi) 11 and translational repression. RNAi leading to post-transcriptional gene silencing (PTGS) is induced by doublestranded RNA (dsRNA) arising from infection by dsRNA viruses, senseantisense transcription pairs, transcription of inverted repeats and delivery of dsRNAs manufactured in vitro 12 . Both endogenous and exogenous dsRNAs are processed cytoplasmically by RNase III dicer paralogs into small interfering RNAs (siRNAs) that are 21-25 bases long 12,13 . These siRNAs are incorporated into an RNA-induced silencing complex (RISC) that targets any RNA with a sequence complementary to the siRNA 12,14 . The target RNA is cleaved by RISC, which has endonucleolytic and presumed exonucleolytic activity 12,15 . Each cycle results in the destruction of the target RNA and the regeneration of an active RISC 16,17 .In Neurospora crassa 18,19 , plants 20 , Schizosaccharomyces pombe 21 and Caenorhabditis elegans 22 , but not in flies, humans or mouse oocyctes 18,19,23,24 , PTGS can also be initiated by an RNA-dependent RNA polymerase (RdRP) that synthesizes complementary RNA from highly expressed transcripts to generate dsRNA. This process can spread from the 3´ to the 5´ end of the mRNA, leading to progressive silencing of a gene and other mRNAs with exons in common (transitive RNAi) 18,22 . From the evolutionary viewpoint, transitive RNAi favors the generation of new phenotypes, as related genes in species with polyploid genomes will escape cosuppression by sequence divergence, resulting in altered function or expression.The number of dicer paralogs also differs between species. Arabidopsis, which has at least four dicer family members, seems to use different enzymes to defend against viruses and to process endogenously produced dsRNA 13,25 . In humans, mice and worms, there is only one dicer ortholog, suggesting that any pathway-specific functions are guided by ancillary regulatory proteins associated with RISC. These ancillary proteins include me...

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“…30 In addition, cultural, social, and physical environments are often shared among members of a family, and some of these factors (eg, high dietary intake of salt) could further increase a child's tendency to become hypertensive. 31 More work will be needed to understand how gene-gene and gene-environment interactions contribute to the familial aggregation of CVD risk.…”

Section: Discussionmentioning

confidence: 99%

Parental History of Hypertension Is Associated With Narrower Retinal Arteriolar Caliber in Young Girls

et al. 2011

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Abstract-We aimed to assess the associations between parental history of hypertension and indicators of cardiovascular risk (retinal vessel diameter, presence of obesity, and elevated blood pressure) in prepubertal children. There were 1739 (77.7% of those eligible) 6-year-old students (863 girls and 876 boys) who were examined from a random cluster sample of 34 Sydney schools. Parents completed questionnaires about their medical conditions, including whether they have/had hypertension. Retinal images were taken with a digital fundus camera, and retinal vessel caliber was quantified using computer software. Anthropometric (height, weight, percentage of body fat, and body mass index) and blood pressure measures were collected. There were 160 children (9.2%) with a positive parental history of hypertension (either biological mother and/or father Although it is clear that parental history has an overall impact on the hypertension risk profile of offspring, it is not known whether the effects of parental history are related to small vessel disease mechanisms. The retinal microvasculature is a microvascular bed that can be observed directly and noninvasively and, therefore, is a surrogate for the systemic microvasculature. 5,6 Consistent evidence is mounting that small vessel disease plays an important role in the development of hypertension and cardiovascular disease (CVD). 5,7,8 Studies in both adult and child populations show that narrower retinal arteriolar caliber and wider venular caliber are associated with CVD risk factors, including obesity and elevated BP. 6,9 -11 Moreover, retinal microvascular changes in adults appear to be structural markers of the subclinical stage of CVD that signals future risk of hypertension and vascular events. 5,7,8 Investigating a possible relationship between parental history of hypertension and the retinal microvasculature in offspring could highlight previously unexplored pathways in future hypertension and CVD development during childhood. We aimed to address 2 key questions in this study of a community-based sample of 6-year old children. First, is parental hypertension associated with adverse microvascular changes indicated by narrower retinal arterioles and wider retinal venules? Second, is parental hypertension associated with an unhealthy cardiovascular risk profile, indicated by adiposity and elevated BP? Methods Study PopulationThe Sydney Childhood Eye Study is a population-based survey of eye conditions in school-aged children from year 1 and 6 who were living within the Sydney Metropolitan Area in Australia. It was

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Family-centered approaches to understanding and preventing coronary heart disease

Cited by 74 publications

References 54 publications

Is Family History a Useful Tool for Detecting Children at Risk for Diabetes and Cardiovascular Diseases? A Public Health Perspective

Is Family History a Useful Tool for Detecting Children at Risk for Diabetes and Cardiovascular Diseases? A Public Health Perspective

The four Rs of RNA-directed evolution

Parental History of Hypertension Is Associated With Narrower Retinal Arteriolar Caliber in Young Girls

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